Fibroids in pregnancy-what you need to know

While many women won’t even experience symptoms caused by fibroids, in a small percentage of cases fibroids can cause significant issues. When this does occur it can happen due to factors such as the size of the fibroids and where they are located.

1. What are fibroids?

Fibroids are non-cancerous (benign) growths which can either develop inside or outside the walls of the uterus (womb). They tend to vary is size and quantity, sometimes a woman many have one or more fibroids at the same time. As many women don’t experience symptoms, it is impossible to give statistics and how many women suffer from fibroids, but it is possible according to the data available, that from 50% to 80% of women have had fibroids.

As we get older, we have a higher chance of getting fibroids, up until the menopause. The reason for this is that fibroids are linked to hormones, and develop from puberty to menopause.

Fibroids usually develop very slowly over the years. Although a definitive cause hasn’t been entirely discovered, fibroid growth has been linked to the oestrogen and progesterone hormones, which can trigger their growth and development. When we reach our menopause, as our hormones change, then normally fibroids will start to shrink.

2. Different types of fibroids

There are four different types of fibroids, which are named depending on their location.

Outside the womb: Subserous fibroids develop from the womb’s outside wall and gorw into the space in the pelvis

On the muscle wall of the womb: Intramural fibroids grow in the womb’s muscle wall

Inner wall of the womb growing into the space inside the womb: Submucous fibroids grow from the womb’s inner wall into the space inside the womb

Stalk type fibroids: Both subserous and submucous fibroids can develop on a stalk. When this occurs they are called pedunculated fibroids.

3. Symptoms of fibroids

Very often fibroids can exist without any obvious symptoms. As they become larger, then symptoms may be noted, these can include:

– Swelling in the abdomen (tummy)

– A feeling of pressure or pain in the pelvis

– Heavy menstruation (periods) that can last longer than normal – this may also lead to anemia, causing dizziness, fatigue and shortness of breath

– A large fibroid can press on the bowel or bladder. So if you feel you need to urinate more frequently, this could be a symptom. Or if it is pressing on the bowel, you may suffer from constipation.

– Fibroids can be a cause for infertility.

If you are currently experiencing any of these symptoms, you should see your doctor.

4. How fibroids are diagnosed

When you go to your doctor, he/she will ask about your symptoms and your medical history. The doctor will examine the lower abdomen and will also carry out a vaginal examination. This investigation is carried out with gloves and lubricant, as your doctor gently feels for anything in the womb or cervix. While doing this, the doctor will place their other hand on the lower part of the abdomen, to apply some pressure.

In the case that your doctor believes you may have fibroids, you may be sent for further tests.

An ultrasound scan: a scan is carried out that looks at the womb from the outside, via the lower abdomen. Additionally you may be scanned using the device that is inserted into the vagina, to investigate the area from the inside. Although this may feel a little uncomfortable, it shouldn’t be painful.

You may have a blood test to find out if you have anaemia.

A hysteroscopy is an examination to look inside the womb. A hysteroscope is used to do this. This is narrow tube-like telescope, which has a camera. During a hysteroscopy, the doctor can also take a small sample of tissue (biopsy) at this time. If small fibroids are present, it may be possible to remove them during a hysteroscopy. The procedure is carried out either with a local anaesthetic or a short general anaesthetic may be administered.

MRI – a magnetic resonance imaging scan can show your fibroids in greater detail, and may be carried out before surgery.

Laparoscopy – a small incision is made in the abdomen, to insert a small camera, which can then show the surgeon how the outside of the womb and inside of the abdomen look. During a laparoscopy, small tissue samples can be taken (biopsies).

Fibroids can also be diagnosed during a gynaecological examination, which you may undergo for a different medical reason, or alternatively if you are examined, because you are having trouble conceiving.

5. Fibroids in pregnancy potential issues & treatment

In some cases fibroids which are present in pregnancy ican lead to problems, such as difficulties during labour, or baby’s development. Fibroids that cause abdominal pain during pregnancy, may carry a risk of pre-mature labour. If the fibroids are large and are blocking the vagina, a caesarean section may be required. In more rare cases, fibroids can lead to miscarriage. Larger fibroids may lead to infertility, and this also depends on where they are positioned.

Painful fibroids in pregnancy are frequently treated with bed rest, ice-packs, and if necessary medication. In general symptoms subside in a few days. If your doctor needs to prescribe medication, he/she will choose the safest option available for you.

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DISCLAIMER

All articles on the blog and website are intended as information only. Please do not consider any of the information provided here as a substitute for medical advice. At all times seek medical advice directly with your own doctor and medical team.